肥胖症诊疗的现代认知及进展

摘要/Abstract

摘要：

肥胖症被定义为一种多因素所致可复发的慢性代谢疾病，病因复杂，危害严重，已引起社会和健康领域的广泛关注。本文系统回顾了近年肥胖症的现代临床诊疗理念和治疗最新进展，提出了以疾病为中心的诊疗理念，结合BMI，引入全新的以脂肪含量和功能障碍为核心的临床诊疗标准，如脂肪分布，内脏脂肪以及腰高比等新的诊断标志，对病人进行全面的评估和全生命周期的管理。近年来，新型生物标志物和人工智能辅助分型技术为肥胖症诊疗提供了新工具。治疗方面，以生活方式和行为干预为基础的联合治疗已被公认，以胰高血糖素样肽1为代表的新型减重药物的问世为肥胖治疗提供了可能，以内镜胃袖状成形术（ESG）为代表的微创技术进一步降低了手术风险，也成为治疗重度肥胖的主力。当前肥胖管理理念已日趋成熟、可行与规范。中心化管理、个体化诊疗的体重管理中心建设原则为实现肥胖症病人的体重长期稳定和促进健康的生活质量提供了保证。

关键词:肥胖症,减重药物,减重手术,人工智能辅助治疗,中心化管理

Abstract:

As a multifactorial chronic metabolic disorder with complex causes and serious health risks, obesity has drawn significant societal and medical attention. This article systematically reviewed the latest advancements in the clinical diagnosis and treatment of obesity. A disease-centered diagnosis and treatment concept has been proposed, which combines BMI and introduces a brand-new clinical diagnosis and treatment standard centered on fat content and functional disorders, such as new diagnostic markers like adipose tissue distribution, visceral adiposity, and waist-to-height ratio, to conduct a comprehensive assessment and lifespan management of patients. In recent years, novel biomarkers and artificial intelligence (AI)-assisted diagnosis have provided new tools for the diagnosis and treatment of obesity. In terms of treatment, combined therapy based on lifestyle and behavioral intervention has been widely recognized. The advent of new weight-loss drugs, such as glucagon-like peptide-1(GLP-1), minimally invasive techniques such as endoscopic sleeve gastrectomy(ESG), which reduced surgical risks, have provided possibilities for the treatment of obesity. The current concept of obesity management has become increasingly mature, feasible, and standardized. The construction principles of a weight management center, characterized by centralized management and individualized treatment, ensure the long-term stability of body weight and promote a healthy quality of life for patients with obesity.

Key words:Obesity,Weight-loss drugs,Bariatric surgery,Artificial intelligence (AI)-assisted therapy,Centralized management

中图分类号:

R589.2

卜乐, 童楚嫣, 曲伸. 肥胖症诊疗的现代认知及进展[J]. 外科理论与实践, 2025, 30(03): 185-191.

BU Le, TONG Chuyan, QU Shen. Modern understanding and advances in the diagnosis and treatment of obesity[J]. Journal of Surgery Concepts & Practice, 2025, 30(03): 185-191.

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